In response to a reader's letter "Time not right for large-scale EMR project":
I have read Stuart Gitlow's comments with great interest. Having given hundreds of seminars on the value of electronic medical records (mostly to primary-care physicians who have vast and complicated needs for assimilating data); I have heard these arguments many times before.
Theoretically medical records are supposed to exist for all the reasons that he outlined. In reality, much of clinical documentation should and could be documented in shorter and simpler ways. Unfortunately, the sad truth is that the medical record exists not only for the clinician but also for trial lawyers and insurance companies. Thus, much is done to maximize reimbursement as well as protect against lawsuits and audits. Since this is the arena we are forced to play in, it makes sense to have the best equipment for this task.
Gitlow states that the EMR "provides the treating physician with a reminder as to what information has been gathered, what treatment has been provided and what response the patient has had to the treatment; and it provides that physician with the ability to share such information with other parties as desired by the patient." Unfortunately, most clinicians are not able to retrieve and view the patient's entire data set. Because care is fragmented and interoperability between disparate record systems is lacking, current use of EMRs remains limited. Advanced decision-support and interoperability tools will completely change the current paradigm for documentation and data presentation. Gitlow states "the time is not yet right to implement the large-scale projects." I must disagree; early adoption of technology is often met with resistance. Should we have held off developing roads, highways and transportation systems until the horseless carriage became a perfect technology?
Joel Diamond, M.D.Chief medical officer, North AmericadbMotionPittsburgh To submit a letter to YOUR VIEWS, click here. Please include your name, title and hometown.